Girls often continue playing soccer with concussion symptoms

NEW YORK (Reuters Health) - Young female soccer players may
get more concussions than their high school and college
counterparts, and many of them continue to play while they have
symptoms, according to a new study.

Concussions can result in memory loss and problems with
concentration and reaction time. The effects are worse when an
athlete suffers a second concussion before fully recovering from
the first.

U.S. high school soccer players get about 50,000 concussions
each year, but no one's been keeping track of concussions among
younger girls, researchers said.

They found 13 percent of those athletes suffered a
concussion each season, and more than half kept playing after
the injury.

"We were surprised at the number of girls reporting symptoms
but more surprised at the number that played despite symptoms
and never saw a health professional for their symptoms," Dr.
John O'Kane told Reuters Health in an email.

O'Kane led the study at the University of Washington's
Department of Orthopaedics and Sports Medicine in Seattle.

"Kids should understand that these symptoms could indicate a
potentially serious injury and that they must stop play when
they occur and notify their parents," he said.

O'Kane and his colleagues studied 351 girls ages 11 to 14
from 33 soccer teams in the Puget Sound area of Washington. They
followed each team for at least one season over a total of four
years.

The researchers sent weekly emails to parents asking if the
girls had suffered any hits to the head that resulted in
symptoms usually associated with concussions. Those include
memory loss, difficulty concentrating, confusion, dizziness,
headaches, ringing in the ears and sensitivity to light or
sound.

If they responded with a yes, players were contacted by
members of the study team and asked more detailed questions,
including if they had been to the doctor and whether they
continued to play with symptoms.

There were 59 concussions during the study, including eight
repeat concussions. Most occurred during games either as a
result of hitting another player or when heading the ball.

The rate of 1.3 concussions for every 1,000 hours of
practice or game time was higher than what has been reported in
studies of female soccer players at the high school and college
levels.

Symptoms lasted an average of nine days, and less than half
of concussed girls sought medical attention. More than 58
percent continued to play with their symptoms, the researchers
reported in JAMA Pediatrics.

O'Kane said parents of athletes in any contact or collision
sport should be aware of the symptoms of concussion and share
that knowledge with their kids. He said it's the parent's
responsibility to ensure that kids with concussion symptoms are
appropriately evaluated before returning to play.

"If you've had a concussion, and then you get a second while
you still haven't recovered from the first, your symptoms are
much worse and they last for much longer," Dr. Amanda
Weiss-Kelly told Reuters Health.

Weiss-Kelly is division chief of pediatric sports medicine
at University Hospitals Rainbow Babies and Children's Hospital
of Case Western Reserve University in Cleveland, Ohio. She
wasn't involved in the new study.

"We have realized there's more going on with concussions
than what we previously thought," she said.

Weiss-Kelly explained that subtle but serious symptoms might
continue for up to two weeks after the initial injury. Memory
loss and problems with concentration may affect kids and how
well they perform in school.

Many concussions happened while the players were heading the
ball - possibly because they hadn't progressed far enough to be
able to perform the maneuver safely.

"It certainly begs the question, 'Should we put off heading
the ball especially in game situations until we think kids are
older and more coordinated and more capable of doing it in an
appropriate fashion?'" Weiss-Kelly said.

She was concerned the general public may start to feel
inundated with concussion education at this point.

"A lot of people think we're swinging too far on the caution
side and I would argue that with kids that's impossible. You
can't be too careful with kids' brains," she said.

"The fact that so few of these kids sought medical attention
proves we haven't done enough."